Gastroschisis and Omphalocele

Gastroschisis and Omphalocele

Jamie C. Harris

Fizan Abdullah


  • Prenatal ultrasound

    • Gastroschisis

      • Prenatal ultrasound will demonstrate intestines within the amniotic fluid, outside of the abdomen.

      • This is most commonly seen around 20 weeks of gestation.2

      • Anomalies, most commonly intestinal atresias, can also be identified on prenatal ultrasound. Bowel dilatation greater than 14 mm is predictive of atresias.1

    • Omphalocele

      • Intestinal contents will be seen outside of the abdomen.

      • The sac can be visualized on ultrasound, helping distinguish from gastroschisis.

      • Additionally, liver can be visualized in the defect.

      • This is seen around 18 weeks of gestation.

      • Evaluations of other associated anomalies, including cardiac, can be done on prenatal ultrasound as well.

  • Postnatal echocardiogram

    • The rate of cardiac anomalies in omphalocele is higher (14%-47%) than in gastroschisis (3%-33%).3

    • Common cardiac anomalies that are seen are ventricular septal defect, atrial septal defect, and tricuspid atresia. A complete cardiac evaluation for omphalocele should be done in the perinatal period.


Preoperative Planning

  • Gastroschisis

    • There are two management strategies for gastroschisis:

      • Delayed closure with silo placement, allowing for reduction of the abdominal contents over the following days

      • Immediate reduction with closure at birth

        FIG 1 • A. Omphalocele presents with a membrane covering and the umbilicus originating from this membrane. B. Gastroschisis presents with a defect in the abdominal wall without a membrane covering the extruded intestines.

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        Feb 27, 2020 | Posted by in Pediatric plastic surgery | Comments Off on Gastroschisis and Omphalocele

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